Abstract

Choroidal Neovascularization (CNV) is the advanced stage of Age-related Macular Degeneration (AMD), which is the leading cause of irreversible visual loss for elder people in developed countries. Optical Coherence Tomography Angiography (OCTA) is a recent non-invasive imaging technique widely used nowadays in diagnosis and follow-up of CNV. In this study, an automatic screening of CNV based on deep learning is performed using OCTA choriocapillaris images. CNV eyes (advanced wet AMD) are diagnosed among healthy eyes (no AMD) and eyes with drusen (intermediate AMD). An OCTA dataset of 1396 images is used to train and evaluate the model. A pre-trained convolutional neural network (CNN) is fine-tuned and validated on 80% of the dataset while the remaining 20% is used independently for predictions. The model can accurately detect CNV on the test set with an accuracy of 89.74%, precision of 0.96 and 0.99 area under the curve of the receiver operating characteristic. A good overall classification accuracy of 88.46% is obtained on a balanced test set. Detailed analysis of misclassified images shows that they are also considered ambiguous images for expert clinicians. This novel CNN-based application is truly a breakthrough to assist clinicians in the challenging task of screening for neovascular complications.

Highlights

  • Age-related Macular Degeneration (AMD) is the leading cause of irreversible blindness in the elderly population of developed countries

  • AMD is characterized by changes in the Retinal Pigment Epithelium (RPE), Bruch’s Membrane (BM), or Choriocapillaris (CC) complex [1]

  • Late AMD consists of wet AMD, characterized by choroidal neovascularization (CNV), and dry AMD, characterized by geographic atrophy (GA) in the macular area [3,4]

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Summary

Introduction

Age-related Macular Degeneration (AMD) is the leading cause of irreversible blindness in the elderly population of developed countries. There are several staging systems for AMD, but the most widely used is the AREDS (Age Related Eye Disease Study) classification, distinguishing between early, intermediate and late AMD (see Figure 1) [2]. Late AMD consists of wet AMD, characterized by choroidal neovascularization (CNV), and dry AMD, characterized by geographic atrophy (GA) in the macular area [3,4]. While both dry and wet AMD are visually threatening, in the particular case of wet AMD, CNV progression can result in rapidly deteriorating visual acuity, leading to scarring and irreversible visual loss [4,5]. Distinguishing between the early, intermediate, and late AMD plays a key role in both follow-up and treatment decisions, in order to preserve the visual prognosis

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